New Microbiol. [JOURNAL]
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200 papers
Evaluation of laboratory parameters in 1587 COVID-19 patients admitted to metropolitan hospital area of Bologna, Italy.
Scapaticci M, Bartolini A, Mancini R
New Microbiol · 2023 May · PMID 37247235
Since the outbreak of the 2019 pandemic coronavirus disease (COVID-19), great attention has been given to identifying the main clinical features of the disease. Identification of laboratory parameters able to classify pa...
Since the outbreak of the 2019 pandemic coronavirus disease (COVID-19), great attention has been given to identifying the main clinical features of the disease. Identification of laboratory parameters able to classify patients based on their risk is mandatory to improve their clinical management. We retrospectively evaluated twenty-six laboratory tests measured in COVID-19 positive patients admitted to the hospital in March and April 2020 to find any correlation between their changes and the risk of death. We divided them into surviving and non-surviving patients. A total of 1587 patients were recruited, 854 males with median age of 71 (IQR 56-81) and 733 females with median age of 77 (IQR 61-87). On admission, death was found to be positively correlated with age (p=0.001), but not with sex (p=0.640) or with hospitalization in days (p=0.827). Brain natriuretic peptide (BNP), creatinine, C-reactive protein (CRP), INR, leukocyte count, lymphocyte count, neutrophil count, and procalcitonin (PCT) demonstrated a statistically significant difference between the two groups (p<0.001), suggesting their role as markers of disease severity; only lymphocyte count resulted as an independent risk factor for death.
BK Virus Infections and Hemorrhagic Cystitis in Allogeneic Hematopoietic Stem Cell Transplant Recipients.
Sökmen H, Öztürk G, Çimentepe M … +4 more , Özen S, Wahhab Alantake HA, Bayram İ, Yarkın F
New Microbiol · 2023 May · PMID 37247234
BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. This study aims...
BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. This study aims to investigate BKV infections and HC in pediatric patients after allogeneic hematopoietic stem cell transplantation. Between November 2018 and November 2019, a total of 51 patients between the ages of 11 months and 17 years were included in the study. BKV Bosphore ® v1 quantification kit (Geneworks Anatolia, Turkey) was used for the detection of BKV DNA in urine and blood samples. Among the total of 51 patients, the incidence of BKV infection was found to be 86.3%. Allogeneic HSCT was performed in 40 patients and autologous HSCT in 11 patients. BK viruria and/or viremia were detected in 85% (44) of patients who underwent allogeneic HSCT and in 90% in the autologous group. High-level BK viruria (>107 copies/mL) was found in 41% (9) of 22 patients who were BKV positive before transplantation, while in 27.5% (8) of 29 patients who were BKV negative before transplantation; thus, BKV positivity before transplantation was considered a risk factor for high-level BK viruria. Acute GVHD developed in 6 of 40 patients in the allogeneic group. HC was prevented in 12 (67%) of 18 patients who received preemptive treatment, while HC developed in 6 (33%). HC occurred at a median of 35 days (17-49 days) post-transplant. Despite preemptive treatment, 6 (15%) patients who developed HC associated with BKV were in the allogeneic group but not in the autologous group. Of these patients with HC, 5 received a myeloablative treatment regimen, and 1 patient was given a reduced-intensity treatment regimen. The viral load in urine was found to be 107-9 copies/mL within 2 weeks before the development of HC and has been identified as a prognostic indicator. In conclusion, early diagnosis of viral infections by monitoring BKV viral load in HSCT patients will be effective in preventing the progression of complications such as BKV-associated HC by providing timely initiation of preemptive treatment.
In Silico Evaluation of SARS-CoV-2 K417N, L452R, and E484K Detection Assays Against Omicron Variants.
Sayan M, Arikan A, Isbilen M
New Microbiol · 2023 May · PMID 37247233
The study's objective was to assess whether the performance of the DIAGNOVITAL SARS-CoV-2 Mutation Detection Assays is affected by Omicron mutations. In silico evaluation of 67,717 Variant of Concern, Variant of Interest...
The study's objective was to assess whether the performance of the DIAGNOVITAL SARS-CoV-2 Mutation Detection Assays is affected by Omicron mutations. In silico evaluation of 67,717 Variant of Concern, Variant of Interest sequences and 6,612 sequences of the Omicron variants involving BA1., BA2., BA3 sub-lineages downloaded from the GISAID database by 17 December 2021, were performed. The sequences were aligned according to the reference genome MN908947.3 using MAFFT multiple sequence alignment software version 7. Our findings showed that among 6,612 Omicron, 41 Spike gene mutations with a frequency of ≥70% were identified. Some of the Omicron mutations (R408S, N440K, G446S, Q493S, Q498R) could affect the diagnostic performance of K417N, L452R, and E484K assays against the Omicron sub-lineages. However, L452R and K417N mutation tests allow differentiation of the Delta and Omicron variants mutation profile. The COVID-19 pandemic lasted longer than expected, and the rapid modification of diagnostic kits seems necessary to combat the pandemic.
Drug resistant tuberculosis in Italy through a global health lens.
Fama F, Genovese C, Raviglione M … +1 more , Gori A
New Microbiol · 2023 May · PMID 37247232
Drug-resistant tuberculosis (DR-TB) is a major global health challenge. In 2021, about one third of DR-TB patients worldwide were enrolled in treatment. In order to reach the targets set during by the 2018 UN General Ass...
Drug-resistant tuberculosis (DR-TB) is a major global health challenge. In 2021, about one third of DR-TB patients worldwide were enrolled in treatment. In order to reach the targets set during by the 2018 UN General Assembly (UNGA) Political Declaration on Tuberculosis, a global effort must be made by both high- and low-incidence countries. Data concerning high-incidence countries are vast in the literature, but insufficient political attention has been paid in low-incidence countries to face this infectious threat. This review aims at providing an overview of DR-TB focused on different facets of DR-TB management. First, global and Italian data on the main at-risk populations for TB and DR-TB were gathered, together with the latest studies on the correlation between TB risk factors and the onset of drug resistance. Second, this review provides an analysis of obsolete Italian guidelines on the diagnosis and management of TB and DR-TB, highlighting the challenges that our country is currently facing to properly implement the latest international recommendations. Finally, some key suggestions are provided to design public health (PH) policies that can effectively tackle the DR-TB issue from a "global health" perspective.
Pragmatic overview on acute bacterial and fungal infections of the central nervous system: a holistic update from diagnosis to treatment.
Giuliano S, Flammini S, Zanus-Fortes A … +6 more , Montanari L, Leanza GM, Attanasio V, Pecori D, Sbrana F, Tascini C
New Microbiol · 2023 May · PMID 37247231
Although progress has led to a drop in infections, meningitis still represents a threat worldwide, affecting some areas more than others. As a medical emergency, it requires prompt recognition and treatment. Moreover, di...
Although progress has led to a drop in infections, meningitis still represents a threat worldwide, affecting some areas more than others. As a medical emergency, it requires prompt recognition and treatment. Moreover, diagnosis relies on invasive methods, while representing a tug-of-war with timely therapeutic interventions, since delays are burdened by mortality and life-long sequalae. While counterbalancing the overuse of antimicrobials, it is imperative to assess correct interventions in order to optimize treatments and reduce negative outcomes. Because the drop in mortality and consequences has been consistent, although not as impactful as with other vaccine-preventable diseases, the WHO has traced a roadmap detailing actions to reduce the meningitis burden by 2030. There are currently no updated guidelines, whereas novel diagnostic methods as well as pharmacological interventions are increasing, along with the shifting epidemiology. In light of the above, this paper wishes to summarize existing data and evidences and suggest potential novel solutions to a complex problem.
Superior vena cava Candida krusei septic thrombophlebitis in an ARDS patient on ECMO, with an unusual late complication.
Iskandar E, Cavanna C, Mollaschi EMG … +3 more , Trani RM, Mojoli F, Amatu A
New Microbiol · 2023 Feb · PMID 36853826
Candida-related bloodstream infections (BSIs) represent a severe condition associated with health care in the critical patient, with an increasing incidence of Candida non-albicans species. These infections could lead to...
Candida-related bloodstream infections (BSIs) represent a severe condition associated with health care in the critical patient, with an increasing incidence of Candida non-albicans species. These infections could lead to several and unusual complications in high-risk patients due to various factors, including a prolonged hospital stay and invasive medical interventions. Here we report a case of a Candida krusei septic thrombophlebitis in an ARDS patient admitted to the ICU, complicated by a late onset prostatic abscess. To our knowledge, our patient represents the first reported case of a prostatic abscess due to Candida krusei treated with pharmacological therapy alone.
Strongyloides hyperinfection syndrome and cytomegalovirus infection in a patient with type II diabetes mellitus.
Wang Z, Guo J, Liu J
New Microbiol · 2023 Feb · PMID 36853825
Strongyloidiasis is a gastrointestinal parasitic infection caused by percutaneous infection with Strongyloides stercoralis, which is mainly distributed in the tropics and subtropics worldwide. Digestive symptoms like dia...
Strongyloidiasis is a gastrointestinal parasitic infection caused by percutaneous infection with Strongyloides stercoralis, which is mainly distributed in the tropics and subtropics worldwide. Digestive symptoms like diarrhea and abdominal pain are the main manifestation, but serious infections such as bacterial pneumonia, purulent meningitis and sepsis also occur in immunocompromised individuals. Herein, we present a rare case of a type II diabetes mellitus (T2DM) patient presented with gastrointestinal hemorrhage and sepsis caused by concomitant Strongyloides stercoralis and cytomegalovirus (CMV) infection. This 51-year-old male patient presented to the hospital with vomiting, diarrhea, dyspnea, palpitation and weakness. Examination revealed skin soft-tissue infection with T2DM, and upper endoscopy revealed gastric mucosal erosion and hemorrhage. Radiology revealed bilateral diffuse interstitial infiltrates and thickened walls of the colon. Importantly, stool and vomitus examination showed numerous larvae of Strongyloides stercoralis. Then the diagnosis of Strongyloides hyperinfection syndrome was made. But antibiotics and albendazole treatment did not improve the patient's symptoms of gastrointestinal bleeding and sepsis. Subsequently, other pathogens were screened by sequence and a positive CMV gene was found in the peripheral blood. Thus, antibiotics, albendazole and ganciclovir were all used which ultimately resolved the infection in this patient. Therefore, this case indicated CMV could also by co-infected with Strongyloides stercoralis in the immunocompromised patient, which remind us that an CMV test should also be performed when encountered in severe strongyloidiasis infection, which could improve the prognosis of the patient.
A COVID-19 mystery: multisystem inflammatory syndrome in adults (MIS-A) associated with splenic rupture.
Isel I, Serin I, Kal Kolik B … +6 more , Goze H, Cinli TA, Huq GE, Cicek ME, Altindal S, Yokus O
New Microbiol · 2023 Feb · PMID 36853824
Severe inflammation and one or more extrapulmonary organ dysfunctions have been observed in those who had recently developed COVID-19, except for a macrophage activation syndrome-like picture. A 50-year-old female patien...
Severe inflammation and one or more extrapulmonary organ dysfunctions have been observed in those who had recently developed COVID-19, except for a macrophage activation syndrome-like picture. A 50-year-old female patient was admitted to the emergency department with fever and a history of COVID-19 infection. More than one area of hemophagocytosis was found in the bone marrow aspiration. The HLH-2004 protocol was started with neurological involvement and she underwent splenectomy due to massive intra-abdominal bleeding secondary to splenic laceration on the 3rd day. Multiple microthrombosis and infarcts were observed in the splenectomy specimen. At the 4th week of the treatment, she was discharged with oral agents. Splenic microthrombosis and splenic rupture due to "multisystem inflammatory syndrome in adults" are the most important findings of this report.
Post-neurosurgical Nocardia meningoventriculitis: a case report and review of the literature.
Ponta G, Bradanini L, Morena V … +6 more , Mauri C, Ripa M, Uberti Foppa C, Castagna A, Luzzaro F, Piconi S
New Microbiol · 2023 Feb · PMID 36853823
The genus Nocardia consists of a group of gram-positive environmental bacteria. They typically cause lung and brain infections in immunocompromised patients, even though one out of three infected patients have a normally...
The genus Nocardia consists of a group of gram-positive environmental bacteria. They typically cause lung and brain infections in immunocompromised patients, even though one out of three infected patients have a normally functioning immune system. Being a ubiquitous microorganism, in some cases Nocardia has been associated with nosocomial acquired infections and surgical procedures. A review of the literature in this field follows the case report. A 47-year-old woman underwent an endoscopic third ventriculostomy and a left retro-sigmoid craniotomy for a schwannoma removal. Meningeal symptoms began a week later, in association with C reactive protein rise and leukocytosis. Cerebrospinal fluid (CSF) examination was clear with hypoglycorrhachia, hyperprotidorrachia and polymorphonuclear cells. Cultural exam was negative. At the brain magnetic resonance imaging (MRI) purulent material was described in the occipital ventricular horns. Empirical broad spectrum antibiotic therapy was given for 31 days until the brain MRI showed a resolution of the infection. Ten days later, the patient was admitted to the hospital because of new meningeal symptoms. Cerebrospinal fluid culture and Polymerase-chain reaction (PCR) Multiplex for the most important meningitis viruses and bacteria tested negative. A broad-spectrum antibiotic therapy was started with no benefit; thus, a broad-spectrum antifungal therapy was added with little success on clinical status. Meanwhile, a 16s and 18s rRNA PCR was executed on a previous Cerebrospinal fluid with negative results, excluding bacterial and fungal infections. For this reason, all the therapies were stopped. After a few days, high fever and meningeal signs reappeared. The brain MRI showed a meningoventriculitis. An Ommaya catheter with reservoir was inserted and the drawn CSF resulted in the growth of Nocardia farcinica. Antibiogram-based antibiotic therapy was started with intravenous imipenem and trimethoprim-sulfamethoxazole, showing clinical benefit. The patient was sent home with oral linezolid and amoxicillin/clavulanate for a total of 12 months of therapy. Nocardia rarely causes post-neurosurgical complication in a nosocomial setting. This case shows the difficulty in detecting Nocardia and the importance of the correct microbiological sample and antibiogram-based antibiotic therapy to achieve successful treatment.
Nocardia infections in Italy: from a local to a national view.
Cordioli G, Di Pietra G, Asa'ad S … +4 more , Meneghello S, Del Vecchio C, De Canale E, Castagliuolo I
New Microbiol · 2023 Feb · PMID 36853822
In this paper, we have described cases of nocardiosis that occurred in our hospital and examined the literature on other nocardiosis cases recorded in Italy. We have collected the clinical details of our recent cases and...
In this paper, we have described cases of nocardiosis that occurred in our hospital and examined the literature on other nocardiosis cases recorded in Italy. We have collected the clinical details of our recent cases and described them in full. Regarding the older cases in our hospital and the Italian cases present in the literature, we noted the clinical data, the Nocardia species involved, and the antimicrobial susceptibility reported. The survey was carried out on PubMed. The first of our cases is an elderly woman with compromised health who had a lung and bloodstream infection. A second case is a middle-aged man who developed an infection in the thigh. A third patient is a middle-aged man on immunosuppressive therapy who developed a cerebral abscess. Our review shows that patients are usually immunocompromised, with an average age of 60 years, and more frequently males. The most affected organs are the lungs and the brain, and the most reported species is Nocardia farcinica. Antimicrobial susceptibility tests show good efficacy of linezolid, cotrimoxazole and amikacin. We conclude that, if a Nocardia infection is suspected, the most likely species to be considered in Italy is N. farcinica. In addition, if empirical therapy is needed, we suggest relying on linezolid, cotrimoxazole or amikacin.
Should we expect weight changes in people with HIV and a reported weight gain only by switching antiretroviral therapy?
Muccini C, Ceccarelli D, Lolatto R … +6 more , Spagnuolo V, Oltolini C, Danise A, Mainardi I, Monardo R, Castagna A
New Microbiol · 2023 Feb · PMID 36853821
Weight gain following the initiation or the switch of antiretroviral therapy (ART) is well documented and mainly associated with some of the most recent drugs, such as integrase strand transfer inhibitors and tenofovir a...
Weight gain following the initiation or the switch of antiretroviral therapy (ART) is well documented and mainly associated with some of the most recent drugs, such as integrase strand transfer inhibitors and tenofovir alafenamide. However, limited data have been published on weight trends in ART-experienced people living with HIV (PLWH) with a long exposure to HIV infection and antiretroviral drugs. In our study, we assessed changes in weight after switching ART among PLWH who reported weight gain under a previous regimen.
Virucidal efficacy of a novel silver-based disinfectant against SARS-CoV-2 Omicron BA.5.
Zani A, Messali S, Caccuri F
New Microbiol · 2023 Feb · PMID 36853820
In this study we evaluated the antiviral activity of the Silver Barrier® disinfectant against SARSCoV-2. Silver Barrier® showed time- and concentration-dependent antiviral activity against SARSCoV-2. After 5 min contact...
In this study we evaluated the antiviral activity of the Silver Barrier® disinfectant against SARSCoV-2. Silver Barrier® showed time- and concentration-dependent antiviral activity against SARSCoV-2. After 5 min contact time, Silver Barrier® at 0.002% showed a strong inhibitory effect (p<0.001), with a 2-fold reduction of viral genome copy numbers, and a robust suppression (94%) of SARS-CoV-2 infectivity. Considering the effects obtained in solution and within a very short time, Silver Barrier® stands as an excellent new candidate for the disinfection of work environments, especially at the healthcare level, where there are people at high risk of serious illnesses.
Characterization of Gardnerella vaginalis isolates: correlations among clades, biofilm formation and cytokine stimulation.
Morselli S, Salvo M, Foschi C … +3 more , Lazzarotto T, Ambretti S, Marangoni A
New Microbiol · 2023 Feb · PMID 36853819
We characterized 61 Gardnerella vaginalis (GV) strains isolated from women with bacterial vaginosis. GV clade 1 was the most commonly found (52.5%), followed by clade 4 (36.1%). All the strains were susceptible to ampici...
We characterized 61 Gardnerella vaginalis (GV) strains isolated from women with bacterial vaginosis. GV clade 1 was the most commonly found (52.5%), followed by clade 4 (36.1%). All the strains were susceptible to ampicillin and clindamycin, whereas 96.7% and 6.6% of strains showed metronidazole and tetracycline resistance, respectively. Isolates within clade 4 tended to possess the highest ability to form biofilm. Strains resistant to metronidazole and tetracycline were all intermediate or high biofilm producers. All GV clades significantly upregulated the production of pro-inflammatory cytokines by HeLa cells, especially IL-8 and IL-6. Clade 4 induced a significantly higher production of IL-1β compared to other clades.
Comparative transcriptome analysis of wild type and a pectate lyase mutant strain of Bacillus subtilis.
Wu K, Wu J, Li X … +3 more , Yang T, Chen X, Yang X
New Microbiol · 2023 Feb · PMID 36853818
Transcriptome analysis for the original Bacillus subtilis K1 strain and UV mutagenic strain UW07 with high yield of pectate lyase was implemented with RNA-seq. The function of genes was annotated and metabolic pathways w...
Transcriptome analysis for the original Bacillus subtilis K1 strain and UV mutagenic strain UW07 with high yield of pectate lyase was implemented with RNA-seq. The function of genes was annotated and metabolic pathways were classified to look for different expression genes and classify these genes into related metabolic pathways to reveal the high-yield mechanism of pectate lyase in UW07. The results showed that 397 genes were up-regulated and 617 genes were down-regulated compared with the original strain. The up-regulated genes were mainly involved in ABC transporters, two-component system, biosynthesis of amino acids, and carbon metabolism.
Progesterone and Estradiol alter the growth, virulence and antibiotic susceptibilities of Staphylococcus aureus.
Kalaycı-Yüksek F, Gümüş D, Güler V … +2 more , Uyanık-Öcal A, Anğ-Küçüker M
New Microbiol · 2023 Feb · PMID 36853817
In the present study, the effects of progesterone (PRO) and estradiol (EST) on the growth, adhesion, invasion, biofilm and antibiotic susceptibilities of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin...
In the present study, the effects of progesterone (PRO) and estradiol (EST) on the growth, adhesion, invasion, biofilm and antibiotic susceptibilities of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) were examined. We also investigated effects of S. aureus infections on the viability of human breast adenocarcinoma (MCF-7) cells in the presence/ absence of hormones. The effects of hormones on the growth, adhesion and invasion of S. aureus were investigated in MCF-7 cells. Growths were assessed spectrophotometrically. Adhesive/invasive bacterial counts were examined by colony counting method. Biofilm was determined using microtiter plate assay. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of ciprofloxacin (CIP) and gentamicin (GN) were examined by the microdilution method. Cell viabilities were detected via methylthiazolyldiphenyl-tetrazolium bromide assay. Growths of bacteria were decreased by hormones (p<0.0001). Adhesion was affected differently depending on hormones and strains tested. Hormones reduced the invasion (p≤0.0001) and biofilm (p<0.0001) of both strains. Progesterone increased and estradiol decreased MIC and MBC of CIP for MRSA; however, MICs of MSSA were not affected. S. aureus infected-MCF-7 viabilities were decreased in the presence of hormones except for high-level PRO (p<0.05). Our results showed that these two hormones have different effects on behaviors of S. aureus strains.
Antimicrobial resistance rates of Streptococcus pyogenes in a Greek tertiary care hospital: 6-year data and literature review.
Meletis G, Soulopoulos Ketikidis AL, Floropoulou N … +6 more , Tychala A, Kagkalou G, Vasilaki O, Mantzana P, Skoura L, Protonotariou E
New Microbiol · 2023 Feb · PMID 36853816
Streptococcus pyogenes is responsible for various clinical manifestations in patients of all ages worldwide. Worryingly, an increase in antibiotic resistance rates of S. pyogenes has been observed in many countries. In t...
Streptococcus pyogenes is responsible for various clinical manifestations in patients of all ages worldwide. Worryingly, an increase in antibiotic resistance rates of S. pyogenes has been observed in many countries. In the present study, 6-year data are presented regarding the antibiotic resistance rates of S. pyogenes in our hospital. During this period, a total of 52 S. pyogenes isolates were recovered from 52 patients and antimicrobial susceptibility testing was performed for 49 isolates. All were susceptible to penicillin, ampicillin, cefotaxime, ceftriaxone, linezolid, moxifloxacin, rifampicin, vancomycin, teicoplanin, and tigecycline. Erythromycin and clindamycin resistance rates were 20.4% and 18.8% respectively. Resistance rates to tetracycline were 40.8%, to chloramphenicol 6.9%, and to levofloxacin 2%. Since macrolides are recommended as an alternative treatment in case of allergy to β-lactams, the high macrolide resistance rates are causing concern. Because different phenotypic antimicrobial patterns for S. pyogenes have been observed in different geographic areas, epidemiological data is of considerable value for the appropriate treatment choices.
Pathogens distribution and antimicrobial resistance pattern of blood stream infections in Southern Italian hospital, 2016-2021 surveillance.
Della Rocca MT, Panetta V, Durante A … +4 more , Bucci L, Matano A, Annecchiarico A, Greco R
New Microbiol · 2023 Feb · PMID 36853815
Bloodstream infections (BSIs) monitoring and antibiotic susceptibility assumes a priority relevance to guide antibiotic treatment strategies and prevention programs. The study aims to identify the most common causative a...
Bloodstream infections (BSIs) monitoring and antibiotic susceptibility assumes a priority relevance to guide antibiotic treatment strategies and prevention programs. The study aims to identify the most common causative agents of BSIs, seasonal distribution and variation of antimicrobial susceptibility rates during a 6-year period in a in a Level II EAD Southern Italian Hospital. The study was conducted from 2016 to 2021 at Hospital of National Relevance (AORN) Sant'Anna and San Sebastiano, Caserta, Campania Region in Italy. BSIs Gram positive causative pathogens were S. aureus and Enterococci; Gram negative pathogens were E. coli, K. pneumoniae, P. aeruginosa and A. baumannii. Seasonal distribution showed the main incidence in April-June for Gram positive BSIs pathogens and in July-September months for Gram negative. Antimicrobial susceptibility fluctuations rates from 2016-2018 to 2019-2021 highlighted a significant decrease in S. aureus oxacillin resistance rates. Enterococci incremented resistance was reported for gentamicin. Gram negative pathogens antimicrobial susceptibility revealed decreased carbapenem-resistance rates for K. pneumoniae (-21.5%) and P. aeruginosa (-19.7%). A. baumannii colistin resistance had a significant increase in 2019-2021. K. pneumoniae and E. coli isolates showed decreased trend of extended-spectrum -lactamase-producing (ESBL) and carbapenem-resistant (CRE) resistance profiles. Our finding reflects the success of our Istitution regarding antimicrobial stewardship program and highlights the need to know the trend of antimicrobial resistance characterization focus on local pathogens' profile. In this way, in conjunction with infection control strategies, il could be possible to constantly reduce the spread of Multi Drug Resistant organisms.
Severe Escherichia coli infections in critical adult patients: two case reports and genomic analysis.
Amadesi S, Virgili G, Marchionni E … +4 more , Cascavilla A, Lazzarotto T, Viale P, Gaibani P
New Microbiol · 2023 Feb · PMID 36853814
Pathogenic Escherichia coli strains can infect a variety of body sites due to the expression of virulence factors necessary to overcome the host defenses. Here, we present two cases of E. coli infection in adults and dis...
Pathogenic Escherichia coli strains can infect a variety of body sites due to the expression of virulence factors necessary to overcome the host defenses. Here, we present two cases of E. coli infection in adults and discuss the associated genomic features. Whole-genome sequencing was performed using both Illumina iSeq 100 and Oxford Nanopore MinION systems. Assembly was carried out with Unicycler using a hybrid approach. The genomes were annotated with RASTtk and scanned for genes involved in antimicrobial resistance, virulence and stress response with AMRFinderPlus. Sequence analysis was conducted using tools from the Center for Genomic Epidemiology (CGE) website. The two strains, named SO80 and SO81, carried a genome of 5,229,956 and 5,437,935 base pairs, respectively. SO80 belonged to ST70 and carried 13 virulence factors, 6 of which were located on a 170 Kb plasmid, while SO81 belonged to ST69 and carried 29 virulence factors, 5 of which were located on a 113 Kb plasmid. Our work highlights key factors which may have contributed to the complicated clinical status of these patients, and provides new in-depth data on E. coli infections with few precedents in the literature.
SARS-CoV-2 infection clinical picture and outcomes in adults living with HIV: a cohort analysis.
Maggiolo F, Comi L, Arosio M … +4 more , Valenti D, Guarneri D, Rizzi M, Callegaro A
New Microbiol · 2023 Feb · PMID 36853813
Existing evidence about HIV and SARS-CoV-2 co-infection has, so far, yield conflicting results. Methods: This is a cohort, single center, clinical study aimed at identifying possible characteristics of PLWH that could co...
Existing evidence about HIV and SARS-CoV-2 co-infection has, so far, yield conflicting results. Methods: This is a cohort, single center, clinical study aimed at identifying possible characteristics of PLWH that could correlate with the risk of acquiring SARS-CoV-2 and would influence the outcome. 155 cases of SARS-CoV-2 infection were compared with 307 PLWH who tested negative. No variable was associated with an increased risk of infection. SARS-CoV-2 PLWH were completely asymptomatic in 20.6% of cases. Factors associated with severe COVID-19 were age (P=0.001), diabetes (P=0.009) hypertension (P=0.004), cardiovascular disease (P=0.001) or an increasing number of chronic co-morbidities (P=0.002); only the first two variables retained statistical significance in a multivariable model. Only older age and a lower CD4 count were statistically associated with death in the multivariate model. Sixteen PLWH not included in the analysis were infected by SARS-Cov-2 after vaccination. In 4 cases the infection was completely asymptomatic, while in the remaining 12 cases the infection was mild and resembled a flu-like syndrome. Conclusions: No baseline characteristic defines patients at greater risk of SARS-CoV-2 infection. Older age and the presence of multi-comorbidities are risk factors for a severe clinical course. Lower CD4 counts correlate with a fatal outcome.
Cefditoren: a clinical overview.
Giuliano S, Acquasanta A, Martini L … +3 more , Sbrana F, Flammini S, Tascini C
New Microbiol · 2023 Feb · PMID 36853812
Cefditoren is an oral third-generation cephalosporin with a large spectrum activity against Gram-negative and Gram-positive bacteria which are reported to be responsible for respiratory tract and skin and skin structure...
Cefditoren is an oral third-generation cephalosporin with a large spectrum activity against Gram-negative and Gram-positive bacteria which are reported to be responsible for respiratory tract and skin and skin structure infections. In this work we reviewed the pharmacodynamics, pharmacokinetics, and the main clinical indications of cefditoren. Similarly to other beta-lactams, cefditoren is a time-dependent antibiotic, and its "best" PK/PD target is probably 40% dosing interval time > 4- 5-fold MIC and 40-70% dosing interval time > 4- 5-fold MIC for bacteriostatic and bactericidal effect, respectively. In fasting patients oral bioavailability is low and increases when the drug is taken with food. This cephalosporin has significant bactericidal activity against S. pneumoniae (both penicillin-susceptible and penicillin-resistant strains), S. pyogenes, H. Influenzae and M. catarrhalis, as well as methicillin-susceptible S. aureus (MSSA). Regarding Enterobacterales, cefditoren has very low MICs90 against K. pneumoniae andE. coli but is not active against AmpC-, ESBL- and carbapenemase-producer' strains. Licensed indications are treatment of exacerbations of chronic bronchitis,acute rhinosinusitis, otitis media, upper respiratory tract infections (pharyngitis/tonsillitis), lower community-acquired respiratory tract infections (LRTIs), and skin and skin-structure infections (SSTI). Cefditoren might have a role in switching from parenteral to oral therapy in acute pyelonephritis and LRTIs. with a reduction of adverse effects and hospital costs. Eventually, due to its supposed binding to enterococcal penicillin binding proteins (PBPs) cefditoren, in combination with other beta-lactams, might have a role in partial oral enterococcal endocarditis treatment..
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